Nature’s Cures:

THE HEALING POWER OF YOGA

When she was in her thirties, Mary Schatz, M.D., a 49-year-old Nashville pathologist on the staff of the Centennial Medical Center, suffered terrible chronic back pain. “I was miserable,” recalls Dr. Schatz, who is also a member of the American College of Sports Medicine, “I had constant pain that took all the fun out of my life.” Dr. Schatz tried everything: pain relievers, bed rest, chiropractic, physical therapy—you name it. Then a friend suggested she try yoga. Dr. Schatz was skeptical. Yoga conjured up images of emaciated men in loincloths and turbans contorting themselves into pretzels for no apparent reason. But she felt she had nothing to lose. “I viewed yoga as my last resort before back surgery, which I really didn’t want.”

At her first yoga class, Dr. Schatz thought she might have accidentally wandered into an aerobic dance studio. Students in leotards or sweat suits were distributed around a large open room and unrolling exercise mats. But unlike aerobics, jazzercise, or any of today’s other dance-for-fitness programs, yoga involves neither loud music, nor cheerleader-style choreography. Instead the room stays quiet, and participants spend a good deal of time remaining relatively still as the teacher leads them in a 60- to 90-minute series of stretches that resemble the warm-up exercises athletes do before events.

But on closer inspection, yoga differs tremendously from athletic warm-ups.

• Yoga is slower. Students might take as long as a minute to ease into stretched postures, and then hold them for up to several minutes before changing positions.

• Yoga is gentler. The old locker-room adage “no pain, no gain” has no place in ancient India’s body-mind workout. If participants feel the least bit uncomfortable attempting any movement, they signal the teacher, who works with them individually to modify the pose so they can perform it comfortably. If that’s not possible, they don’t do it.

• Yoga involves the whole body. Most exercise programs concentrate on the large muscle groups: the arms, legs, and abdominals. The typical yoga class works these muscles as well, but also spends time flexing the fingers and toes, and rolling the eyes, wrists, and ankles, thus exercising muscle groups most other fitness programs ignore.

• Yoga is surprising. It works up a sweat, but it’s not aerobically strenuous. After class, participants usually feel more relaxed than tired. People of any age can practice it, and unlike most exercise programs, so can those with serious physical limitations, for example, heart disease, multiple sclerosis, and severe arthritis.

• Yoga is meditative. While stretching into the various postures—some as simple as standing up straight, others as challenging as headstands—participants breath slowly and deeply, and enjoy the relaxation and mind-clearing benefits of meditation (see Chapter XX, “Meditation”).

Yoga was certainly different from anything Dr. Schatz had tried for her back. Its results were different as well. Almost immediately, her back began to feel less painful and more flexible. As she continued to practice, her back pain disappeared. “Yoga was amazingly therapeutic for me. I can honestly say that it changed my life. Now I practice yoga every day. My husband does it when his back hurts. And my stepson has used it to control the knee pain he developed playing basketball.” Dr. Schatz also used yoga as the basis for her book, Back Care Basics (see Resources)

Dr. Schatz is not the only physician to discover the healing power of yoga. About 15 years ago, William E. Connor, M.D., a professor of medicine and clinical nutrition at the Oregon Health Sciences University in Portland, developed chronic hip pain. “My daughter practiced yoga, and encouraged me to try it. I was very skeptical, but she insisted, so I figured I’d humor her for a while. At first I couldn’t even do the poses she showed me. But after a while, they came more easily—and my hip improved. Now I don’t have hip pain anymore, except when I don’t do yoga for a few days.”

A year after Dr. Connor began practicing yoga regularly, his wife had to have surgery after a skiing accident. “She couldn’t take pain relievers because of a stomach problem, so I encouraged her to try yoga. It helped her considerably. Now we do it together.”

Dr. Connor particularly enjoys the fact that yoga is completely portable. “All you need is about 10 square feet of floor space. You don't need any special clothing, or equipment, or a gym. It’s as easy to do in a hotel room as it is at home. I practice 10 minutes a day, and take an hour-long class once a week. Yoga has improved my body, mind, and spirit. No wonder it's been around for thousands of years.”

Another physician who uses yoga therapeutically is Dean Ornish, M.D., whose revolutionary natural treatment for heart disease is the subject of Chapter XX. “Yoga is a very powerful system for stress management that complements Western approaches to medical care.”

Yoga is generally practiced by healthy people who want a gentle, relaxing form of exercise that develops flexibility and strength. But as Drs. Schatz, Connor, and Ornish attest, yoga has become increasingly popular for those with chronic medical conditions. Lorna Bell, R.N., coauthor of Gentle Yoga, and former director of the YMCA Health and Fitness Program in Cedar Rapids, Iowa, developed a yoga class specifically for people with disabilities, particularly arthritis, multiple sclerosis, stroke, and paraplegia (see Resources). Participants have reported significant physical benefits and general improvement in their quality of life. “Yoga has helped me considerably,” says John Jenney, a retired salesman who was diagnosed with multiple sclerosis in 1977. “My balance definitely improved.”

Science Documents Yoga’s Benefits

Testimonials, like those above, may be moving, but most scientists dismiss them as merely “anecdotal evidence,” curiosities that may or may not hold up under rigorous experimental scrutiny. But yoga’s benefits have been demonstrated over and over again in more than 100 scientific studies. Most have been conducted in India, yoga’s birthplace where it is a major pillar of India’s traditional Ayurvedic medicine (see sidebar). But studies showing the many benefits of yoga have also been conducted in the U.S. and Europe and published in leading Western scientific journals. Here is a sampling of recent findings:

• Arthritis. Gentle stretching exercises that move sore joints through their full range of motion are a key to managing arthritis. Dr. Connor says yoga stretches and postures encourage range-of-motion movements without unduly stressing arthritic joints.

• Asthma. Many studies have shown than yoga helps asthma patients reduce medication and gain control over their breathing by relaxing the respiratory system. In 1992, Fort Collins, Colorado, allergist Pudupakkam K. Vedanthan, M.D., described a study he conducted at the annual meeting of the American Academy of Allergy and Immunology in Orlando, Florida. Dr. Vedanthan divided 17 asthmatics, aged 19 to 52, into two groups. Both groups received standard medical care, but one also enrolled in a yoga class, three times a week for 12 weeks. Afterwards, the yoga group reported decreased use of asthma medication, fewer bronchospasms, less anxiety about their condition, improved physical condition, and less likelihood to experience exercise-induced asthma symptoms.

Several other studies have produced similar results: A 1993 Indian study of 46 chronic asthma sufferers showed that yoga’s benefits—decreased medication needs, improved lung function, and ability to exercise—endured one year after the yoga class ceased. A 1991 study in the Journal of Asthma showed similar improvement in 46 children with asthma. And 1990 British experiment showed that yoga eases asthmatics’ breathing and reduces the likelihood of asthma attacks.

• Diabetes. Diabetics who are not dependent on insulin injections may still have trouble maintaining normal blood sugar (glucose) levels. A 1993 Indian experiment enrolled 149 non-insulin-dependent diabetics in a yoga class lasting 40 days, and then assessed any effects on their condition. Yoga helped normalize their blood glucose levels, reducing their need for medication.

• Pain Control. A 1991 report in the International Journal of Psychsomatics urges physicians to recommend yoga for the management of chronic pain. Effective nondrug approaches to pain control include: relaxation training, deep breathing, and gentle exercise, all of which are combined in yoga.

• Mental Retardation. In a 1989 study, scientists at the Yoga Research Foundation in Bangalore, India, divided 90 mentally retarded children into two groups. Both received standard education and medical care, but in addition, one group practiced yoga for five hours a week for one school year. The yoga group showed “highly significant improvement” in IQ and social skills.

• Mood and Energy. In a 1993 study, British researchers tested three different relaxation therapies—chair sitting, visualization, and 30 minutes of yoga—on 71 participants ranging in age from 21 to 76. Yoga produced the greatest increase in feelings of alertness, mental and physical energy, and enthusiasm for life. “Yoga,” the researchers concluded, “is simple to learn and can be practiced even by the elderly. It had a markedly invigorating effect and increased positive mood.”

• Stress Management. “Deep breathing and moderate exercise are two fundamentals of many stress management programs,” Dr. Schatz says. “Yoga includes both. Most people who practice regularly usually say it helps them control everyday stresses, tensions, and anxieties."

• Total Physical Conditioning. In a 1993 study, Indian researchers recruited 40 physical education teachers who were in excellent shape but had never done yoga. They measured the teachers’ blood pressure, lung function, heart and respiratory rates, and hand steadiness before and after three months of yoga training. Despite the teachers’ admirable initial physical condition, yoga conferred many benefits: improved lung function, reduced blood pressure, decreased heart and respiratory rates, and improved hand steadiness.

A 1992 Indian study tested yoga’s effects on hand grip strength and reaction times to visual and auditory cues. Twenty-seven college students were tested before and after 12 weeks of yoga training. The class significantly increased their grip strength and decreased their reactions times. Faster reaction times suggest that yoga might improve highway safety.

“Exercise advocates generally tout aerobic exercise for cardiovascular fitness,” Dr. Connor says. “Cardiovascular fitness is certainly worth developing, but aerobic exercise isn't everything. The body also needs workouts that build flexibility, and it's hard to top yoga for flexibility.”

Finally, yoga also offers mental and spiritual benefits, Dr. Connor says. “They’re hard to measure, but most people who practice regularly report mental invigoration and feelings of greater well-being. I don’t consider yoga a religion. But many people say that like meditation, it has deepened their appreciation for the spiritual side of life.”


Of course, yoga is no cure-all. Drs. Conner and Schatz say people with asthma, arthritis, diabetes, back problems, and other medical conditions should not throw away their medications or abandon their physicians in favor of yoga classes. “But in addition to regular medical care, yoga can be quite beneficial for many chronic illnesses,” Dr. Connor says.

Yoga American Style

To many Americans, the 4,000-year-old Indian art of yoga is still an exotic import from India, a workout for spiritual seekers who have gurus. But during the century since Swami Vivekananda was first applauded for his yoga performance at the 1893 Chicago World’s Fair, yoga’s combination of gentle postures, stretches, and deep breathing has become as American as several other Indian imports, for example, ginger and cinnamon.

The word “yoga” comes from the Sanskrit for “yoke,” as in the joining of two oxen in a disciplined union. To appreciate was yoga is, it helps to understand what it is not. It’s not a religion, though it developed from Hinduism. It’s not calisthenics, though it works up a sweat, and tones and strengthens the muscles and joints as well as—or better than—most forms of exercise. And it’s not meditation, though it’s slow pace, deep breathing, and focus on the moment open a door to meditative relaxation. Longtime practitioners describe yoga as a physical path to uniting the mind, body, and spirit.

There are six major types of yoga, but only two have gained a foothold in the West, hatha yoga and tantra yoga. Hatha is by far the more popular. It’s what people mean when they say “yoga,” the stretches and postures Indian yoga masters call asanas. Hatha means “forceful,” which is ironic because a hallmark of American yoga is its gentleness. But hatha yoga’s roots penetrate deep into the same spiritual soil that nurtured the martial arts in China, the energy that uses physical determination to achieve spiritual goals. Today there are several schools of hatha yoga. The most popular is Iyengar yoga, developed by B.K.S. Iyengar, who modified the classic hatha asanas for the comfort of Western practitioners.

Tantra yoga is a meditative form of self-transcendence through elaborate rituals including ritual sexuality, the focus of its practice in the West. But genuine tantra involves a great deal more than sex. Many Indian schools of trantra yoga recommend celibacy.

Hatha yoga dates back to the 11th century, when Gorakshanatha distilled several thousand years of yogic practices into the forerunners of the asanas practiced today, focusing on posture and breath control (pranayama). It was meant for what Hindus call kali-yuga, a time when few people can devote themselves entirely to spiritual pursuits, yet still crave some activity that unites the mind, body, and spirit.

The best way to learn yoga, Dr. Schatz says, is to enroll in a class taught by a well-trained teacher you like. “There are many different styles of yoga,” she says, “but Iyengar yoga instructors are rigorously trained, not only in the postures themselves, but in adapting them to beginners and to those with disabilities, chronic illnesses, or other special needs.”

Yoga classes abound around the U.S., in every metropolitan area and in many out-of-the-way places as well. Ask friends, inquire at gyms or aerobic studios, or look in the Yellow Pages under Yoga. In addition, Yoga Journal publishes a directory of Yoga teachers around the country.

If you’re traveling or can’t get to a yoga class, you can turn on the TV and do yoga with Lilias, whose early-morning program on PBS is nationally syndicated. “She's very good,” Dr. Connor says. Or try Yoga for Beginners, an engaging 75-minute video produced by Yoga Journal, a leading resource in the field (see below).

Dr. Connor calls yoga “generally safe,” but says some postures aren't for everyone: “Depending on a person’s disease or disability, certain poses might cause problems. Headstands can be a problem for people with glaucoma. And certain stretches might need to be modified for people with back, knee, or other musculoskeletal problems. But one of yoga’s attractions is that, unlike so many other forms of exercise, good teachers can usually adapt the postures to the special needs of people with chronic medical conditions. Yoga is usually a good form of exercise for people with health problems."

Before enrolling in a yoga class (or starting any exercise program), people over 60 or those with disabilities or chronic medical conditions should consult their physicians. In addition, anyone with a medical problem who decides to pursue yoga should confer with the teacher before enrolling to discuss modifying or abstaining from any problematic postures.

Sidebar:
For Best Results from Yoga...
Iyengar teachers Hart Lazer, of Winnipeg, Canada, and Donald Moyer, of Berkeley, California, recommend:

Regularity. At least one session a week, ideally one at the same time six days a week, with the seventh a rest day.

Environment. Practice in a clean, quiet, flat space, out of direct sunlight.

Eating. Don’t eat for two hours before practicing.

Health. Practice only when you’re in reasonably good health. Don’t practice when you feel ill, especially if you have a fever.

Pain. Learn to distinguish between stretching sensations, which are beneficial, and pain, which is not. If you feel any sharp pain, stop what you are doing, and try to modify the pose. If pain persists, stop doing the posture until you consult with a yoga teacher.

Menstruation. During menstruation, women should not perform inverted postures—headstand or shoulder stand.

Pregnancy. Consult a yoga teacher about practicing while pregnant. Abdominal postures are not recommended, and others will need to be modified as pregnancy progresses.

Warm-Ups. Begin yoga sessions with several nondemanding warm-up postures, for example, Mountain Pose, Standing Leg Stretches, Downward-facing Dog, and Sun Salutation.

Focus. While practicing, keep your mind on the pose, your breathing, and your emotional response(s) to your practice of yoga.

Flow. “In each pose,” Iyengar quips, “there should be repose.” Don’t bounce into postures, or force yourself. Allow them to develop gradually. Flow into them. Beginners who cannot perform the postures unassisted should use props: a chair, blocks or books, and rolled up towels or blankets.

Sidebar:
A Yoga Sampler
Most yoga sessions involve 15 to 30 poses. Here are seven that almost anyone can do. The directions come from two longtime teachers of Iyengar yoga, Donna Farhi, a frequent contributor to Yoga Journal who teaches yoga workshops around the world, and Patricia Walden, star of the Yoga for Beginners video, who teaches in Somerville, Massachusetts.

Mountain Pose. The basis for all standing poses, Mountain Pose teaches correct posture, which is a boon to health and well-being even when you’re not practicing yoga. Stand with your feet together, big toes touching, heels slightly apart, arms hanging at your sides. (If you feel unstable with your feet together, separate them slightly.) Distribute your weight evenly between your two feet, and between the ball and heel of each foot. Your kneecaps should face forward. Focus on your pelvis. Balance it atop the legs, neither tucking the tailbone (which pushes the pelvis forward), nor overarching the back (which pushes it back). Now feel your body rise upward from your feet. Stretch your inner legs up from the inner heels to the groin. Relax the diaphragm and extend the spine upward from the pelvis. Open your chest. Breath deeply and slowly from your diaphragm. Drop your shoulders and relax your face and eyes. Your shoulders, hips, and heels should be in a line. Hold the pose for up to one minute.

Jumping to the Wide-Leg Standing Pose. Jumping is both a pose and an elegant transition from Mountain Pose to the other standing poses. Do it on a nonslip surface. Do not jump if you have ankle, knee, hip, or back problems, or if you are pregnant. Instead of jumping, step. To jump, begin in Mountain Pose, then inhale and bend the knees slightly. Also, raise your arms to shoulder height, and bend them at the elbow so that your middle fingers touch in front of your lower neck. Then jump your feet outward as you extend your arms straight out. There’s no need to jump high. The jump should be silent and graceful. You should wind up with your feet parallel, pointing forward, and three to four feet apart and now quite in line with your wrists. To return to Mountain Pose, follow this sequence in reverse.

Triangle Pose. Begin in Mountain Pose then jump to the Wide-Leg Standing Pose. Pivot on your heels, turning the left foot in 60&Mac251; and your right foot out 90&Mac251;. Place a prop block or pile of books behind your right ankle. The right heel should be in line with the arch of the left foot. Distribute your weight evening between your feet and each foot’s ball and heel. Spread and lengthen your toes. Do not overextend your knees. Use your front thigh muscles to draw the kneecaps upward. Inhale, and as you exhale, bend from the hips and extend your torso over your right leg. Place your right hand down on the block. (If you can reach comfortably, place your hand on the floor.) Raise your left arm over your head, palm forward. On an exhalation, turn your head and look up at your left hand. Feel the floor beneath your feet, and relax into lengthening your spine, legs, and arms. If you neck begins to ache, look forward. Hold the pose for up to 30 seconds on each side. Afterward, return to the Wide-Leg Standing Pose, and them jump to Mountain Pose.

Side Stretch Pose. Begin in Mountain Pose, then jump your feet wider apart than you would for Triangle Pose so your ankles and wrists are in line. Turn your left foot in and your right foot out. Bend your front (right) leg to that your thigh and lower leg form a right angle at the knee. Your right knee should be directly above your right ankle. Keep your left leg strong and planted as you bend your right knee. Bending from the hips, extend your torso over your right thigh. Place your right hand on a block (or the floor). Press your feet into the floor and extend your left arm overhead, palm forward. Feel your spine stretch up through your left fingertips. On an exhalation, gently turn your neck and look up at the ceiling. Hold the pose for up to one minute on each side. Afterward, return to the Wide-Leg Standing Pose, and them jump to Mountain Pose.

Proud Warrior Pose. Begin in Mountain Pose, then jump to Wide-Leg Standing Pose, with your feet under your wrists. Imagine a line from the top your head down through the center of your torso to your tailbone. Maintain an awareness of this line as you turn your left foot in and your right foot out. On an exhale, bend your right knee to form a right angle, with your knee directly over your right ankle. On your next exhalation, turn your heat and look at your right hand. Press your feet into the floor, and feel your spine lengthen. Afterward, return to the Wide-Leg Standing Pose, and them jump to Mountain Pose.

Standing Forward Bend #1. Begin in Mountain Pose, standing two to three feet behind a chair with your feet parallel and hip-width apart. Place your hands on your hips, and on an exhale, bend forward from the hips. Bend your arms, clasping your elbows. Place your forearms on top of the back of the chair, and rest your forehead on your arms. Relax your spine. Hold the pose for up to one minute. Afterward, return to Mountain Pose. This pose may strain the backs of pregnant women.

Standing Forward Bend #2. Begin in Mountain Pose, standing with your back about one foot away from a wall. Place your palms on the wall, and rest your buttocks against the wall. Step your feet about hip-width apart, keeping your feet parallel. Lengthen and spread your toes. Inhale, placing your hands on your hips. On an exhale, bend forward from the hips. As you bend forward, bend your arms and clasp your elbows. Relax your spine, releasing your head and neck. Extend your arms beneath your head. Hold for up to one minute. Afterward, return to Mountain Pose. This pose may strain the backs of pregnant women.

Resources:
Back Care Basics by Mary Pullig Schatz, M.D. (Rodmell Press, Berkeley, CA). You don’t have to have a bad back to benefit from this clear, basic introduction to yoga.
Gentle Yoga: For People with Arthritis, Stroke Damage, Multiple Sclerosis, in Wheelchairs, Or Anyone Who Needs a Guide to Gentle Exercise by Lorna Bell, R.N. and Eudora Seyfer. (Celestial Arts, Berkeley, CA, 1987)
Light On Yoga by B.K.S. Iyengar (600 photos, Schocken Books, NY, revised edition, 1979). Iyengar’s adaptations of the classic postures were instrumental in popularizing yoga in the U.S.
Yoga Journal. The most comprehensive yoga resource. It lists classes and workshops around the country. Contact: 2054 University Ave., Berkeley, CA 94704
Yoga for Beginners. Produced by Yoga Journal. A 75-minute, color video, starring Patricia Walden, who teaches at the B.K.S. Iyengar Yoga Center in Somerville, Massachusetts. Comes with a 52-page instruction booklet. Contact Healing Arts Publishing, 321 Hampton Dr., Suite 203, Venice, CA 90921. Yoga Journal and Healing Arts have also collaborated on three other videos: Yoga for Relaxation, Yoga for Flexibility, and Yoga for Strength.